Patient Journey: Herniated Discs, From Diagnosis to Recovery

Patient discussing herniated disc treatment with doctor

A herniated disc is one of the most common sources of back pain – but how does a patient go from diagnosis to recovery? Centers for Neurosurgery, Spine & Orthopedics (CNSO) understands that each patient’s experience and personal circumstances are unique. Finding the best spine treatment option for each individual and facilitating a quick road to recovery is crucial to a patient’s overall well-being. For patients willing to travel to northern New Jersey, CNSO provides consultations and treatments in multiple offices and top-ranking New Jersey hospitals. Learn more about herniated discs and what CNSO patients experience during their road to recovery which is faster than the national averages.

Assessing the Symptoms of a Herniated Disc

The first step on the patient journey is awareness – a patient with a ruptured disc or slipped disc may feel pain or tingling sensations in their neck, shoulders, back, arms, or legs. Normally these discs of the spine between each bone of the spine called vertebrae, provide cushioning between the joint connections of each vertebrae. These flat, round discs are comprised of a soft, spongy interior (nucleus populous) and a tougher exterior layer (annulus). Their unique design allows for flexibility of the back while also providing shock absorption.

Sometimes, there is damage to the joint bones themselves. At the same time or even without spine joint damage, the disc becomes weak or damaged by trauma cracking the annulus, called a rupture or a tear. When the annulus is torn, the nucleus populous then extrudes out, protruding through the exterior layer and extending outwards resulting in compression of the adjacent nerve roots and spinal cord within the spinal column – this is called a disc herniation or a slipped disc. Depending on the location of the herniated disc, the patient will experience noxious symptoms within the area where the spinal cord or nerve roots innervate the body.

For instance, signs of a cervical herniated disc (neck) include:

  • Burning, shooting, or severe pain in the shoulder blade, upper trapezius, arm, and hand
  • Numbness or tingling in the arm and shoulder blade
  • Weakness in the arm or hand
  • Weakness in the shoulder
  • Quadriplegia
  • Paralysis
  • Difficulty with fine motor skills

Signs of a lumbar herniated disc (back) include:

  • Shooting, burning, or severe pain radiating into the buttocks, groin, leg, and foot
  • Numbness or tingling in the buttocks, leg, or foot
  • Muscle weakness in different parts of the leg, loss of balance, or “drop foot”
  • Paralysis
  • Sciatica symptoms

The symptoms experienced depend on the severity of disc extrusion outside of its normal location. Patients will experience neurological symptoms when the contents of the disc push against the surrounding neuronal structures. The disc contents may also release material that leads to nerve inflammation and the resulting discomforting symptoms.

Herniated Disc Diagnosis

Once the patient is aware something is wrong, they might visit their primary healthcare provider, urgent care center, or hospital. Or they may realize they need to see a spine specialist which is either a pain management doctor, a neurosurgeon, or an orthopedic spine surgeon. The sooner the patient seeks medical attention, the sooner they can get on the path to recovery.

During an examination, the physician will ask the patient questions about their symptoms. They also will perform a physical examination, checking for numbness, reflex issues, and positions or movements that provoke and relieve the pain. Things a patient can expect during the diagnosis phase include:

  • Range of motion test to see how far the spine can move in each direction and which motions cause pain
  • Neurological assessment to pinpoint the source of the symptoms
  • Palpation (manual manipulation) of the muscles and other structures
  • Diagnostic imaging, such as an X-ray, CT scan, or MRI
  • Electromyography (EMG) test to measure muscle activity and the level of communication between nerve and muscle

Reviewing Spinal Treatment Options

When the spine health specialist has confirmed the diagnosis as a disc herniation, they will discuss treatment options with the patient. Since each patient’s circumstances are unique, treatment plans are personalized to help ensure the quickest recovery and best results.

Initially, the physician’s goal is to relieve pain, inflammation, and muscle spasms, so the patient can be comfortable while the cause of the discomfort is resolved. Often, both are accomplished through over the counter medication, physical therapy, and sometimes epidural steroid injections in combination. Not all herniated discs, however, are remedied through conservative means – sometimes surgical intervention is necessary because of the extent of the herniation and associated symptoms. Surgical treatments for herniated discs include:

  • Discectomy to remove a portion of the spinal disc(s) and relieve nerve pressure.
  • Minimally invasive surgery uses dilators allowing for extremely small incision sites that aid in a rapid recovery.
  • Microdiscectomy – When only a portion of a disc needs to be removed. This technique also utilizes extremely small incision sites that aid in a rapid recovery.
  • Total Disc Replacement – Referred to as arthroplasty of a disc. A native disfigured cervical disc is replaced with a biosynthetic mechanical disc which allows for optimum mobility of the neck and avoids a fusion.
  • Laminectomy to remove portions of the lamina (bony arches on the spine) and relieve nerve or spinal cord compression.
  • Fusion surgery to reinforce unstable portions of the spinal column.

Back or neck surgery typically is recommended for patients whose symptoms do not improve, progressively worsen, or when symptoms limit daily life despite conservative care, or when weakness and loss of function occur.

Herniated Disc Recovery

Most patients with herniated discs recover through rest, hot/cold compresses, NSAIDs medication, oral steroids, then physical therapy, and possibly epidural and transforaminal steroid injections as conservative treatments. The amount of time it typically takes to heal on its own ranges from four to six weeks, depending on the location and severity of the condition. Recovery also depends on the types of treatments the patient receives during that time. For example, physical therapy and epidural injections in conjunction with at-home care can help make this period easier.

If it is determined that spine surgery is the best course of action, the recovery timeframe from a simple one level discectomy until pain free can be the same day. A one level discectomy or laminectomy typically is accomplished by CNSO surgeons, within one hour. More extensive spine fusion surgery can take longer, and the recovery will be longer. Patients are given specific instructions to help ensure they heal well, such as:

  • Initially adjust or limit strenuous activity
  • Avoidance of bending, lifting, and twisting motions for a short time period after surgery
  • Participate in physical therapy rehabilitation if the surgeon orders it to optimize and speed up your recovery

Trust CNSO for Outstanding Herniated Disc Care

The award-winning, compassionate team at CNSO includes orthopedic spine surgeons, neurosurgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and physical therapists, ensuring each patient can receive the comprehensive care they need for herniated discs and other conditions. Contact CSNO today to schedule an appointment at one of the convenient locations in northern New Jersey.

Centers for Neurosurgery Spine & Orthopedics